ASPIRATION OF FASCIOLA HEPATICA METACERCARIAE FROM LIVER ABSCESS: A RARE CASE REPORT
*Dr. Dhanwantari Shukla, Varsha Shukla and Vishnu Kumar Patel
ABSTRACT
Human Fascioliasis is a zoonotic disease caused by trematodes – Fasciola hepatica and Fasciola gigantica[1] and present clinically either as an acute hepatic phase or a chronic biliary phase.[2] They are diagnosed directly by parasitological identification of eggs in stool or metacercariae/adults in hepatobiliary fluids or indirectly by detection of antigens in serological tests. Imaging techniques provide a useful aid in diagnosis. Most of the flukes are retrieved from common bile duct either during open exploration or ERCP. USG guided bile aspiration from gall bladder or Common Bile Duct is another important mode of retrieval. Rarely analysis of gall bladder or CBD stones reveal calcified flukes and aspiration of liver abscess may yield flukes. Triclabendazole is the drug of choice.[3] Here, we report a rare case of aspiration of live metacercariae of Fasciola hepatica from the liver abscess of a 22 year old male who presented to us with fever and pain in the right upper quadrant of abdomen. Introduction: The possibility of Fasciola hepatica should be kept in mind when dealing with cases of hepatic abscesses, hepatitis and chronic CBD obstruction. Its impact and wide emergence has prompted the World Health Organization (WHO) to include human fascioliasis on its list of priorities among neglected tropical diseases (NTDs).[4] Its diagnosis is challenging as no single test claims good predictive value but once the diagnosis is made by a combination of tests or repeating the tests serially, the treatment is rather easy and rewarding unless life-threatening complications have set in. A high index of clinical suspicion combined with timely intervention can go a long way in dealing with this emerging public health problem.
Keywords: Fasciola hepatica, metacercariae, liver abscess.
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